Can J Emerg Med
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The aim of the study is to determine the performance of low-dose ketamine (LDK) as an analgesic for acute pain management in adult patients in the emergency department (ED). ⋯ There are moderate to low quality data supporting LDK as an alternative analgesic in the ED with the potential for minimal requirement of rescue analgesia and self-limited neuropsychological adverse events.
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The acquisition of competence in diagnostic reasoning is essential for medical trainees. Exposure to a variety of patient presentations helps develop the skills of diagnostic reasoning, but reliance on ad hoc clinical encounters is inefficient and does not guarantee timely exposure for all trainees. We present a novel teaching series led by emergency physicians that builds upon the existing medical education literature to teach diagnostic reasoning to preclinical (2nd year) medical students. ⋯ Emergency physicians coached and provided immediate feedback to the students as they actively worked through diagnostic reasoning. The participating medical students reported benefit from these sessions immediately following the sessions and in an 18-month follow-up survey where the students could consider the impact of the sessions on their clinical clerkship. Students felt that the sessions had assisted them in recognizing the key features of relevant diagnoses during clerkship as well as providing a helpful adjunct to their in-class learning.
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Introduction The International Federation for Emergency Medicine (IFEM) Ultrasound Special Interest Group (USIG) was tasked with development of a hierarchical consensus approach to the use of point of care ultrasound (PoCUS) in patients with hypotension and cardiac arrest.
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The predominant causes of acute mechanical small bowel obstruction in geriatric patients are adhesions and hernias, which is not much different than in other adult age groups. Unusual etiologies may be encountered, such as volvulus or gallstone ileus, but a displaced feeding gastrostomy tube is a distinctly rare cause of intestinal obstruction which needs to be considered by emergency physicians as it may be increasingly encountered.
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Review Case Reports
Infant Strangulation from an Amber Teething Necklace.
Amber teething necklaces supposedly provide analgesia for teething infants. Their use is becoming more widespread, despite lack of peer-reviewed evidence and warnings from Health Canada that they pose a strangulation and aspiration risk. ⋯ We will also discuss the role of physicians as advocates in reporting similar cases and educating families. Finally, we will comment on the responsibility of all professionals and professional organizations that work with infants and toddlers to advocate for children by raising concerns and counselling parents.